Hi Dr. Bob,

I hope I haven't offended you. I just want to thank you for taking the time to answer my questions. Truly, I would reread your answers to me several times daily as I waited through the window period.

This was my situation: http://www.thebody.com/Forums/AIDS/SafeSex/Current/Q198643.html

These are the results after 12 weeks since exposure (86 days): - Negative HIV 1/2 antibody - Negative for Hepetitis A, B, C - Negative for Syphilis - Negative throat culture for gonorrhea - Negative urine analysis for gonorrhea and chlamydia

My questions: 1) Are there any other STD tests that I should have?

2) Do I need to repeat any of these tests at 6 months?

3) How realistic are the risks for HIV O or N?

4) How did you find a great guy like Dr. Steve? I clearly need to stay out of the bathhouses and meet real partners in real places. Got any advice for a young gay puppy such as myself on how to meet guys?

Finally about five weeks ago, I shook hands with an HIV+ man who had lots of moisturizer on his hands. At first, I told myself that I could wipe my hands on my pants and that there was no risk for transmission. My fear/anxiety/OCD got the better of me - I freaked out.

5) Do I need to get tested following this experience?

6) Is a 12-week test good even though this individual is confirmed to be positive?

I realize these last few questions are insulting to those with the disease, and I truly do not mean to offend you. You are a very kind, clever, and supportive individual. I ask because I'm trying to counter my fears with logic and reason, and I know that you can provide that.

I promise I will make another donation to your organization. Hope you and Dr. Steve are doing well.

Thank you once again.

Hi,

How could you have offended me? Did you vote for Palin or something like that?

1. Assuming you have no symptoms that require specialized testing, your results to date cover the major STDs and I do not feel additional tests would be warranted.

2. No.

3. Not realistic at all. You have a greater chance of being struck by lightening than contracting an O or N strain.

4. We met at work. Bathhouses may be convenient places to get off, but I doubt you'll find your Mr. Right in the orgy room. Try meeting guys with similar interests (other than bathhouses), such as hobbies, mutual friends, guys with similar jobs, etc.

5. No, absolutely not.

6. Testing is not warranted.

Dr. Bob

Follow Up - Scared, ARS-like Symptoms After Mutual Masterbation Jan 11, 2009

Doctor,

I hope you are having a Happy New Year. I'm in a bit of a crisis and I need your help.

On Dec. 3, I went to a bathhouse. There were a few risk incidents: 1) Sucked unknown partner for 30 seconds, don't think there was pre-cum, 2) used said partners precum as lube on raw penis, later noticed red open sore near the head and frenulum, 3) said partner fingered my anus while sucking me off, and 4) made out with a seperate guy who was biting my lips, tongue, and neck aggressively before I put an end to it.

Two weeks later, I had ARS-like symptoms (fever, sore throat, diarrhea, night chills, 16-pound weight loss).

On Day 20 after exposure, I saw an HIV specialist who ordered a viral load test (Roche COBAS Ampliprep Taqman) that came back undetectable.

Since then, my lymp nodes have gotten swollen. I saw the doctor again who refused to order anymore tests.

Is my undetectable HIV PCR RNA test (with 50ml sensitivity) really Whoo-Hoo-able? Should I find another doctor? Or do I need your good luck karma for a 3-month test?

I'm seeing a therapist to help me with the anxiety. I deeply regret going to that place.

Please respond, Doctor. I'm really scared and I'm afraid that maybe the HIV specialist is overlooking HIV-2, non B subclades, and other testing options because he wants me to come out of the closet (and I've started telling my friends who are helping through this - I'll tell my family as soon as I'm confirmed to be HIV- so they won't have to worry).

I'll send a donation to your fund, Doctor.

Please help me.

Response from Dr. Frascino

Hello,

Your HIV-acquisition risk from the activities you describe are extremely low. Your negative HIV PCR RNA at day 20 is extremely encouraging and I have no reason to question your HIV specialist's opinion. He has much more information about the specifics of your particular situation than I do. Certainly the option to take a three-month HIV-antibody is open to you. The odds are astronomically in your favor the results will be negative.

My advice is to continue working with your therapist to cope with your anxiety, fears of HIV infection, sexual orientation issues and your coming out process. Remember closets are health hazards!

Your fears of missing an HIV-2, non-B subclade, etc. are unwarranted.

Thank you for your tax-deductible donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). I'm sending you my good-luck/good-health karma that you'll come out and learn to cope better with your sexual orientation, your HIV fears and that you'll remain HIV negative as an out and proud healthy gay man.

Good luck. Be well.

Dr. Bob